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CORRESPONDENCE
Year : 2018  |  Volume : 147  |  Issue : 2  |  Page : 208

Authors' response


1 Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India
2 Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India

Date of Submission09-Jan-2018
Date of Web Publication25-May-2018

Correspondence Address:
S K Bhadada
Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-5916.233211

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How to cite this article:
Bhadada S K, Rastogi A, Agarwal A, Kochhar R, Kochhar R, Bhansali A. Authors' response. Indian J Med Res 2018;147:208

How to cite this URL:
Bhadada S K, Rastogi A, Agarwal A, Kochhar R, Kochhar R, Bhansali A. Authors' response. Indian J Med Res [serial online] 2018 [cited 2020 Jul 10];147:208. Available from: http://www.ijmr.org.in/text.asp?2018/147/2/208/233211

We agree that beneficial effect of gluten free diet (GFD) on glycaemic control in T1DM with celiac disease is not yet supported by large randomized studies. However, a small study by Amin et al[1] documented that switching to GFD improved body mass index and HbA1C in patients with T1DM with celiac disease. To reach a meaningful conclusion on this issue results from large longitudinal studies are needed.

We agree that screening of celiac disease in T1DM individuals is most productive till 10 years of age [2]. However, we feel that screening should be continued in later life also if symptoms or signs are not explained by T1DM alone. It is known that elevated tissue transglutaminase IgA antibodies are spontaneously normalized in some patients [3], so diagnosis of celiac disease should be made in conjunction with intestinal mucosal biopsy suggestive of celiac disease with elevated tissue transglutaminase IgA antibodies [4]. It will help to prevent from prescribing GFD to individuals with T1DM, and those already on significant dietary restrictions. In our study celiac disease was diagnosed as per European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHN) criteria [4].



 
   References Top

1.
Amin R, Ahmed ML, Murphy N, Acerini CL, Edge J, Dunger DB. A longitudinal study of the effects of a gluten free diet on glycemic control and weight gain in subjects with type 1 diabetes and celiac disease. Diabetes Care 2002; 25 : 1117-22.  Back to cited text no. 1
[PUBMED]    
2.
Pham-Short A, Donaghue KC, Ambler G, Chan AK, Craig ME. Coeliac disease in type 1diabetes from 1990 to 2009: Higher incidence in young children after longer diabetes duration. Diabet Med 2012; 29 : e286-9.  Back to cited text no. 2
[PUBMED]    
3.
Castellaneta S, Piccinno E, Oliva M, Cristofori F, Vendemiale M, Ortolani F, et al. High rate of spontaneous normalization of celiac serology in a cohort of 446 children with type 1 diabetes: A prospective study. Diabetes Care 2015; 38 : 760-6.  Back to cited text no. 3
[PUBMED]    
4.
Revised criteria for diagnosis of coeliac disease. Report of Working Group of European Society of Pediatric Gastroenterology and Nutrition. Arch Dis Child 1990; 65 : 909-11.  Back to cited text no. 4
[PUBMED]    




 

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